This is somewhat out of my league but I will put my 2 cents in anyway and those of you have have had adenoma's please correct me if I'm wrong.

First, do they know for sure the adenoma was secreting prolactin? Not all are. Your prolacting was not extremely high which you tend to see with prolactinomas I thought.

Second, it is very possible the adenoma is causing other pituitary issues like low LH. Your LH is low considering your T levels are so low. If the high prolactin was causing LH to be low by reducing GnRH from the hypothalmus then I would have expected it to be higher on the test when prolactin was not measurable. So what I'm saying is LH may continue to be low due to pressure on the pituitary from the adenoma, not from high prolactin.

If the high prolactin was not from the adenoma then I do not know all the other causes of high prolactin. I know having an orgasm will jump it up for a few hours. Did you happen to have one before the test was done where it was slightly high?

What kind of treatment is tough and is a personal choice. Obviously if you want to have kids though you either have to get LH and FSH up or you will have to be on HCG to keep the testicles stimulated. Your decision at this point seems to be do you have the adenoma removed or not. If not you will likely be on hormone replacement for life and this should include HCG to keep you fertile. Do not believe the doctor that says we will give you HCG when you are ready for kids. Sometimes the atrophy that has occured in the testicles may not be reversable by that point. If you go for the surgery find a university hospital that specializes in pituitary surgery. It is very difficult surgery to get right. There is a website that specializes in pituitary disorders you can look for. They give lists of hospitals too I believe.

Yes I think most if not all your symptoms are most likely from the adenoma and resultiing hormones out of balance. In any event treat the problem you know you have and see if it cures all the symptoms.